Perceptions of contraceptive methods: a multidimensional scaling analysis

Is users' knowledge about contraceptives adequate? A case study of Finnish IUD users

Intrauterine contraceptive devices (IUDs) are popular: in Finland, in 1987, about 25% of women of childbearing age used them. We studied Finnish women's knowledge about contraindications for and side-effects of IUD use, with emphasis on current users. In December 1987-January 1988, a postal questionnaire was sent to a random sample of 1000 women of childbearing age, in Uusimaa province, which includes the capital, Helsinki. After three reminders, the response rate was 84%. We compared the answers of current and past users and nonusers of IUDs, and analyzed the associations between IUD use, education, age, and knowledge about side-effects. In contrast to the recommendations for use and information to be given to the contraceptive users, a substantial proportion of current IUD users assumed there are few limitations for IUD use. Some side-effects possibly leading to severe consequences were not considered to be connected with IUD use, not even by users. Although risk of infection was a quite well known fact, infertility was seldom associated with IUD use, and 22% of current IUD users did not associate ectopic pregnancy with IUDs. The results thus suggest that contraceptive counseling is not fully adequate and should receive more attention.

The attitude/behavior discrepancy as a methodological artifact: comment on 'sexually active adolescents and condoms'

A recent questionnaire-based study published in the American Journal of Public Health found that although sexually active adolescents both believe that the use of condoms offers protection against sexually transmitted diseases and value such protection, they do not intend to use (or have their partners use) condoms. This attitude/behavior discrepancy is more apparent than real. Six methodological problems in the study are discussed in detail in order to demonstrate how the overly simplified treatment of a complex behavior can lead to invalid conclusions.